Fertility preservation in patients with early cervical cancer: radical trachelectomy

Abstract

Objectives: The goal of this review is to summarize the latest literature on the subject of radical trachelectomy and fertility outcomes in patients with early-stage cervical cancer.

Methods: We analyzed the published literature in search of all articles addressing surgical techniques, intraoperative and perioperative outcomes, and obstetrical results in patient undergoing radical trachelectomy for cervical cancer.

Results: It is estimated that 43% of all cases of cervical cancer in the United States are diagnosed in women younger than 45 years of age. As of 2007, a total of 520 patients had been reported to have undergone a radical vaginal trachelectomy. The majority of patients (60%) had a diagnosis of squamous cell carcinoma; adenocarcinoma was the second most common histologic subtype (40%). Data on outcomes after radical abdominal trachelectomy are less extensive-only approximately 50 cases have been reported worldwide. Approximately 43% of patients who undergo a radical trachelectomy subsequently attempt to become pregnant. Seventy percent of these women are successful at achieving a pregnancy.

Conclusions: Radical trachelectomy is safe and feasible and pregnancy outcomes are very favorable. All patients interested in future fertility who are diagnosed with cervical cancer are encouraged to discuss radical trachelectomy with their physician.